The following is a summary of “Associations of Symptom Clusters and Health Outcomes in Adult Survivors of Childhood Cancer: A Report From the St Jude Lifetime Cohort Study,” published in the January 2023 issue of Oncology by Shin, et al.

For a study, researchers sought to find symptom clusters in adult cancer survivors and investigate links to physical and cognitive function and health-related quality of life (HRQOL).

About 3,085 survivors from the St Jude Lifetime Cohort Analysis (mean age at evaluation 31.9 ± 8.3 years; mean years from diagnosis 28.1 ± 9.1) were included in the cross-sectional study. About 37 symptoms covering 10 categories (cardiac, pulmonary, sensory, motor/movement, nausea, pain, exhaustion, memory, anxiety, and depression) were self-reported by survivors. In addition, the Physical Performance Test evaluated physical performance, the Short Form-36’s Physical/Mental Component Summaries evaluated HRQOL, and the neurocognitive batteries evaluated attention, processing/psychomotor speed, memory, and executive function. Using latent class analysis, subgroups of survivors with various symptom load patterns were discovered (i.e., symptom clusters). Regression models with many variables assessed relationships between cluster membership risk and health outcomes.

There were found to be four distinct symptom clusters: cluster 1 (prevalence 52.4%; low physical, somatization, and psychologic domains); cluster 2 (16.1%; low physical, moderate somatic, and high psychologic domains); cluster 3 (17.6%; high physical, moderate somatic, and low psychologic domains); and cluster 4 (13.9%; high in all three domains). When compared to survivors in cluster 1, survivors in cluster 4 were more likely to have completed less than a high school education (odds ratio [OR], 7.71; 95% CI, 4.46 to 13.31), had no insurance (OR, 1.49; 95% CI, 1.04 to 2.13), and had been exposed to corticosteroids (OR, 1.76; 95% CI, 1.02 to 3.03); while survivors in cluster 3 were more likely to have received platinum agents (OR, 2.22; 95% CI, 1.34 to 3.68) and brain radiation ≥ 30 Gy (OR, 3.99; 95% CI, 2.33 to 6.86). In addition, compared to survivors in the other clusters, survivors in cluster 4 had the lowest Physical Component Summary/Mental Component Summary scores (31.0/26.7), as well as the worst physical and neurocognitive performance (P< .001).

Moderate to high multisymptom load was connected to sociodemographic, therapeutic, HRQOL, and functional outcomes in almost 50% of survivors.

Reference: ascopubs.org/doi/full/10.1200/JCO.22.00361